Articles

Improving perception and confidence towards bystander cardiopulmonary resuscitation and public access automated external defibrillator program: how does training program help?

In conjunction with an automated external defibrillator (AED) placement program at various locations within a public university in Malaysia, a series of structured training programs were conducted. The objecti...

Authors: Siew Yee Liaw, Keng Sheng Chew, Ahmad Zulkarnain, Shirly Siew Ling Wong, Nariman Singmamae, Dev Nath Kaushal and Hiang Chuan Chan

Factors influencing termination of resuscitation in children: a qualitative analysis

Pediatric Advanced Life Support provides guidelines for resuscitating children in cardiopulmonary arrest. However, the role physicians’ attitudes and beliefs play in decision-making when terminating resuscitat...

Authors: Rashida T. Campwala, Anita R. Schmidt, Todd P. Chang and Alan L. Nager

A dignitary medicine curriculum developed using a modified Delphi methodology

Dignitary medicine is an emerging field of training that involves the specialized care of diplomats, heads of state, and other high-ranking officials. In an effort to provide guidance on training in this nasce...

Authors: Mobarak A. Al Mulhim, Robert G. Darling, Ritu Sarin, Alex Hart, Hetaf Kamal, Abdullah Al Hadhirah, Amalia Voskanyan, Lewis Hofmann, Bradley A. Connor, Roger A. Band, James Jones, Richard Tubb, Ronny Jackson, Amado Alejandro Baez, Edward Wasser, Sean Conley…

Accuracy of Broselow tape in estimating the weight of the child for management of pediatric emergencies in Nepalese population

Children with emergency conditions require immediate life-saving intervention and resuscitation. Unlike adults, the pediatric emergency drug dose, equipment sizes, and defibrillation energy doses are calculate...

Authors: Pukar K.C., Akhilendra Jha, Kamal Ghimire, Roshana Shrestha and Anmol Purna Shrestha

Position within the hospital and role in the emergency department of emergency physicians in the Netherlands: a national survey

Emergency medicine (EM) in the Netherlands has developed rapidly and initially without central guidance. This has led to heterogeneity in current EM practice. Our aim was to quantify this heterogeneity by answ...

Authors: Sarah Coppes, Rebekka Veugelers, Roger A. P. A. Hessels, Crispijn L. van den Brand and Menno I. Gaakeer

Developing an integrated emergency medical services in a low-income country like Nepal: a concept paper

The main aim of emergency medical services (EMS) should be to provide universal emergency medical care which is EMS system available to all those who need it. Most of the developed countries have an integrated...

Authors: Deepak Bhandari and Nabin Krishna Yadav

Methanol outbreak: a Malaysian tertiary hospital experience

Methanol poisoning usually occurs in a cluster and initial diagnosis can be challenging. Mortality is high without immediate interventions. This paper describes a methanol poisoning outbreak and difficulties i...

Authors: J. Md Noor, R. Hawari, M. F. Mokhtar, S. J. Yussof, N. Chew, N. A. Norzan, R. Rahimi, Z. Ismail, S. Singh, J. Baladas, N. H. Hashim, M. I. K. Mohamad and M. D. Pathmanathan

Cohort retrospective study: the neutrophil to lymphocyte ratio as an independent predictor of outcomes at the presentation of the multi-trauma patient

Although the association of neutrophil to lymphocyte ratio (NLR) with mortality in trauma patients has recently been shown, there is a paucity of research on the association with other outcomes. Recent studies...

Authors: Soulaiman Elias Soulaiman, Dalal Dopa, Al-Batool T. Raad, Walaa Hasan, Niyazi Ibrahim, Al-Ykzan Hasan, Hussam Aldin Sulaiman and Moufid Darwich

Are pre-existing psychiatric disorders the only reason for involuntary holds in the emergency department?

To determine the role of previous psychiatric disorders including substance use disorders on emergency department (ED) patients on involuntary holds and compare presentations, treatment, and outcomes based on ...

Authors: Christian Lachner, Michael J. Maniaci, Tyler F. Vadeboncoeur, Nancy L. Dawson, Teresa A. Rummans, Archana Roy, Lorrina L. Hall and M. Caroline Burton

Pericardial effusion with tamponade: bedside ultrasonography saves another life

In these video clinical images, the authors present the cause for an elderly gentleman’s shortness of breath. It was presumed to be an exacerbation of chronic obstructive pulmonary disease, a condition for whi...

Authors: Javier Rosario, Rohan Mangal, Jessica Houck, Mary Cate Slome and Latha Ganti

Euglycemic diabetic ketoacidosis caused by canagliflozin: a case report

Diabetic ketoacidosis (DKA) is seen relatively frequently in the emergency department (ED). DKA is characterized by hyperglycemia, acidosis, and ketonemia, and sodium glucose transporter 2 inhibitors (SGLT2i) ...

Authors: Masafumi Fukuda, Masakazu Nabeta, Takanori Muta, Kei Fukami and Osamu Takasu

Eagle syndrome masquerading as a chicken bone

This is a brief report of a 17-year-old male who presented to the emergency department with odynophagia and a foreign body sensation in the throat after choking on a chicken wing. A soft tissue neck radiograph...

Authors: Jason E. Cohn, Sammy Othman and Karima Sajadi-Ernazarova

A 2-year-old with a hepatic abscess secondary to an ascending retrocecal appendicitis: case report and review of the literature

Diagnosing appendicitis within the pediatric population can be challenging, whether it be a neonate with irritability or a toddler with flank pain. Symptoms may mimic a viral illness, constipation, urinary tra...

Authors: Gregory M. Taylor, Ethan R. Saffer, Eric L. McDowell and Matthew A. Warpinski

The influence of past experiences on future willingness to perform bystander cardiopulmonary resuscitation

The influence of past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events toward willingness to “pay it forward” by help...

Authors: Keng Sheng Chew, Shazrina Ahmad Razali, Shirly Siew Ling Wong, Aisyah Azizul, Nurul Faizah Ismail, Sharoon Juliet Kun Chyee Ak Robert and Yegharaj A/L Jayaveeran

Right main bronchus rupture associated with blunt chest trauma: a case report

Tracheobronchial injury is one of the least common injuries in the scenario of blunt chest trauma. However, around 81% of patients with airway injury die immediately or before arriving at the emergency departm...

Authors: Carime Díaz, Daniel F. Carvajal, Eliana I. Morales, Saveria Sangiovanni and Liliana Fernández-Trujillo

Fluid resuscitation in trauma: what are the best strategies and fluids?

Traumatic injuries pose a global health problem and account for about 10% global burden of disease. Among injured patients, the major cause of potentially preventable death is uncontrolled post-traumatic hemor...

Authors: G. H. Ramesh, J. C. Uma and Sheerin Farhath

Developing an emergency medicine handoff tool: an electronic Delphi approach

Handoffs at the end of clinical shifts occur with high frequencies in the emergency department setting and they pose an increased risk to patients. There is a need to standardize handoff practices. This study ...

Authors: Khaled Alrajhi and Abdulmohsen Alsaawi

Triage and flow management in sepsis

Sepsis is a major public health problem, with a growing incidence and mortality rates still close to 30% in severe cases. The speed and adequacy of the treatment administered in the first hours of sepsis, part...

Authors: Hudson Henrique Gomes Pires, Fábio Fernandes Neves and Antonio Pazin-Filho

Exploring emergency department visits: factors influencing individuals’ decisions, knowledge of triage systems and waiting times, and experiences during visits to a tertiary hospital in Saudi Arabia

In recent years, there has been an increased utilization of emergency departments (EDs) in many countries. Additionally, it is reported that there are major delays in delivering care to ED patients. Longer wai...

Authors: Nawaf Alhabdan, Faisal Alhusain, Abdulkareem Alharbi, Muatassem Alsadhan, Moath Hakami and Emad Masuadi

A compulsive act of excess water intake leading to hyponatraemia and rhabdomyolysis: a case report

Primary polydipsia is commonly seen in patients with psychiatric illnesses. Excess water intake is also seen in patient with anorexia and anticholinergic medications. We report a patient who had hyponatraemia ...

Authors: Sudheera Fernando, Francisca Sivagnanam and Devarajan Rathish

Rhabdomyolysis as an initial presentation of systemic lupus erythematosus: a case report

Systemic lupus erythematosus (SLE) is a multi-system autoimmune disease which most commonly presents in women of reproductive age. It takes a relapsing-remitting course and may manifest as a variety of clinica...

Authors: Gayatri Saxena and Ahmed Mahdi

Case report: systolic murmur associated with pulmonary embolism

This case study’s novelty lies in the potential to link a new sign in pulmonary embolism diagnosis which does not increase cost but could lead to more rapid treatment. Early intervention in these cases is vita...

Authors: Cain M. Dudek, Kelly R. McCracken and B. James Connolly

Outcomes of rapid response team implementation in tertiary private hospitals: a prospective cohort study

Cardiopulmonary arrest may result in high mortality rate in hospitals where the rapid response team is not implemented. A rapid response system can recognize patients at high risk of cardiopulmonary arrest and...

Authors: Awad Al-Omari, Abbas Al Mutair and Fadi Aljamaan

To enhance the quality of CPR performed by youth layman

By educating laymen, survival after cardiac arrest can increase in society. It is difficult to reach the entire population with cardiopulmonary resuscitation (CPR) training. However, if 15% of the population k...

Authors: Anna Abelsson and Annette Nygårdh

Impact of age on the seasonal prevalence of hypernatremia in the emergency department: a single-center study

Hypernatremia is one of the most commonly encountered electrolyte disorders in the emergency department (ED). Few studies have reported the seasonal fluctuations of the prevalence of hypernatremia with conflic...

Authors: Naohiko Imai, Hirofumi Sumi and Yugo Shibagaki

Complete brachial plexus palsy following shoulder dislocation due to sneeze: a case report

Traumatic shoulder dislocation is a frequent condition presenting to the emergency department. Due to the anatomy of the shoulder, associated neurovascular damage is not uncommon. Although clinical intuition m...

Authors: Austin H. Middleton, John Roffers and Dean W. Ziegler

Euglycemic diabetic ketoacidosis associated with sodium-glucose cotransporter-2 inhibitor use: a case report and review of the literature

The sodium-glucose cotransporter-2 (SGLT2) inhibitors are the newest class of anti-hyperglycemic medications used in the treatment of diabetes mellitus. Their increasing use has been driven by their apparent c...

Authors: Alexis Diaz-Ramos, Wesley Eilbert and Diego Marquez

Prospective comparison of capillary and venous brain biomarker S100B: capillary samples have large inter-sample variation and poor correlation with venous samples

Guidelines for the emergency management of mild traumatic brain injury have been used for over a decade and are considered safe. However, they recommend computerized tomography for at least half of these patie...

Authors: Tomas Vedin, Mathias Karlsson, Marcus Edelhamre, Mikael Bergenheim and Per-Anders Larsson

Chest pain while gardening: a Stanford type A dissection involving the aortic root extending into the iliac arteries—an uncommon and potentially catastrophic disease process

An aortic dissection is an uncommon and potentially catastrophic disease process that carries with it a high morbidity and mortality. The inciting event is a tear in the intimal lining of the aorta. This allow...

Authors: Gregory M. Taylor, Michael W. Barney and Eric L. McDowell

Clinical significance of urinary L-FABP in the emergency department

This study’s aim is to measure liver-type fatty acid-binding protein (L-FABP) levels in urine using a rapid semiquantitative assay kit in the emergency department and to investigate whether the onset of acute ...

Authors: Ginga Suzuki, Ryo Ichibayashi, Saki Yamamoto, Yoshimi Nakamichi, Masayuki Watanabe and Mitsuru Honda

New d-dimer threshold for Japanese patients with suspected pulmonary embolism: a retrospective cohort study

In the diagnosis of pulmonary embolism (PE), the d-dimer threshold is based on studies conducted in Western countries, where the incidence rate is 5 times higher than that in Asian countries, including Japan. If ...

Authors: Jin Takahashi, Takashi Shiga, Yuita Fukuyama, Yuiko Hoshina, Yosuke Homma, Michiko Mizobe, Kenji Numata, Tetsuya Inoue and Hiraku Funakoshi

Complications of subcutaneous penile modifications: a discussion of emergency department presentations and management

Subcutaneous penile modifications (SPMs) are more prevalent in Southeast Asian culture and have been growing in popularity in Western culture. SPMs are often made of domino tiles, or other available pieces of ...

Authors: Cali L. Kirkham, Stormy M. Monks and Scott B. Crawford

The impact of a multimodal intervention on emergency department crowding and patient flow

The objective of this study is to assess the impact of a multimodal intervention on emergency department (ED) crowding and patient flow in a Dutch level 1 trauma center.

Authors: M. C. (Christien) van der Linden, H. M. E. (Jet) van Ufford and N. (Naomi) van der Linden

Effect of new year holidays on hospital mortality: a time series study

Nowruz holidays, as one of the most important holidays in Iran, can lead to changes in the trend of hospital deaths. Due to changes in lifestyle and increased accidents, hospitals become crowded during the hol...

Authors: Mohadeseh Ghanbari Jahromi, Reza Goudarzi, Vahid Yazdi-Feyzabadi, Saeed Amini, Javad Nazari and Mohammadreza Amiresmaili

Interdisciplinary in situ simulation-based medical education in the emergency department of a teaching hospital in Nepal

Simulation is well established as an effective strategy to train health care professionals in both technical and nontechnical skills and to prevent errors. Despite its known efficacy, adequate implementation i...

Authors: Roshana Shrestha, Anmol Purna Shrestha, Sanu Krishna Shrestha, Samjhana Basnet and Alok Pradhan

Epidemiology of paediatric trauma in Norway: a single-trauma centre observational study

Trauma is a major cause of mortality and morbidity in children globally. The burden of injury shows substantial geographical differences, with a significant mortality reduction in children in Norway during the...

Authors: Eirik Nesje, Nadine Nalini Valøy, Andreas Jorstad Krüger and Oddvar Uleberg

The importance of platelet counts in severe hypothermia

Authors: Ian Joseph Cohen

Emergency medicine in Saudi Arabia: a century of progress and a bright vision for the future

Although emergency medical services (EMS) and pre-hospital care have existed in the Kingdom of Saudi Arabia (KSA) since 1934, emergency medicine (EM) is a relatively new medical field in the country that was n...

Authors: Eyad Khattab, Abdulrahman Sabbagh, Nawfal Aljerian, Hashim Binsalleeh, Mobarak Almulhim, Abdulrahman Alqahtani and Majid Alsalamah

A comparison of airway management devices in simulated entrapment-trauma: a prospective manikin study

In the patient entrapped after a motor vehicle collision (MVC), advanced airway management may need to be performed before extrication. The aim of this study was to compare four airway management devices utili...

Authors: Robin Pap and Charl van Loggerenberg

Outcomes following clonidine ingestions in children: an analysis of poison control center data

This paper sought to characterize pediatric clonidine ingestions, report trends in incidence, and evaluate outcomes using the Florida Poison Center’s data over a period of 15 years, from 2002 to 2016.

Authors: Kendra Amico, Rolando Cabrera and Latha Ganti

Medical students and metrics: seven techniques for a win-win situation

The authors present seven winning strategies for maintaining a rich academic environment for learners while working in a busy emergency department with expected productivity metrics.

Authors: Tracy MacIntosh, David C. Lebowitz and Latha Ganti

Differences in initial electrocardiographic findings between ST-elevation myocardial infarction due to left main trunk and left anterior descending artery lesions

Early discrimination of ST-elevation myocardial infarction (STEMI) due to a left main trunk (LMT) lesion provided by straightforward electrocardiographic criteria is useful for prompt treatment. The purpose of...

Authors: Toshiharu Fujii, Misaki Hasegawa, Junichi Miyamoto and Yuji Ikari

Improving the ability of ED physicians to identify subclinical/electrographic seizures on EEG after a brief training module

Approximately 5% of emergency department (ED) patients with altered mental status (AMS) have non-convulsive seizures (NCS). Patients with NCS should be diagnosed with EEG as soon as possible to initiate antiep...

Authors: Geetha Chari, Kabir Yadav, Daniel Nishijima, Ahmet Omurtag and Shahriar Zehtabchi

Quick SOFA vs Rockall preendoscopy scores for risk assessment in patients with nonvariceal upper gastrointestinal bleeding: a retrospective cohort study

Several scoring systems are used to evaluate the severity of nonvariceal upper gastrointestinal bleeding (NVUGB) and the risk of rebleeding or death. The most commonly used scoring systems include the Rockall ...

Authors: Vladimir Bagin, Evgenii Tarasov, Maria Astafyeva, Evgenii Nishnevich, Vladimir Rudnov and Mikhail Prudkov

A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness

Physicians are occasionally faced with patients requesting full resuscitation against medical advice. More commonly, neither patients nor their family members make such a request, but physicians simply presume...

Authors: Loukas Georgiou and Anastasios Georgiou

It’s not just FaceTime: core competencies for the Medical Virtualist

New applications for virtual healthcare have resulted in an expansion of medical care beyond traditional healthcare settings. However, the rapid development of telemedicine as a field has resulted in poor stan...

Authors: Rahul Sharma, Sapir Nachum, Karina W. Davidson and Michael Nochomovitz

A pilot study of improvised CPAP (iCPAP) via face mask for the treatment of adult respiratory distress in low-resource settings

Continuous positive airway pressure (CPAP) is a mode of non-invasive ventilation used to treat a variety of respiratory conditions in the emergency department and intensive care unit. In low-resource settings ...

Authors: Brendan H. Milliner, Suzanne Bentley and James DuCanto

Team-based learning improves knowledge and retention in an emergency medicine clerkship

Team-based learning (TBL) as an instructional pedagogy is increasingly recognized to improve student engagement, value of teamwork, and performance on standardized assessments when compared to traditional lect...

Authors: Arif Alper Cevik, Margaret ElZubeir, Fikri M. Abu-Zidan and Sami Shaban

Implementation and performance of the South African Triage Scale at Kenyatta National Hospital in Nairobi, Kenya

Triage protocols standardize and improve patient care in accident and emergency departments (A&Es). Kenyatta National Hospital (KNH), the largest public tertiary hospital in East Africa, is resource-limited an...

Authors: Ali A. Wangara, Katherine M. Hunold, Sarah Leeper, Frederick Ndiawo, Judith Mweu, Shaun Harty, Rachael Fuchs, Ian B. K. Martin, Karen Ekernas, Stephen J. Dunlop, Michèle Twomey, Alice W. Maingi and Justin Guy Myers

Evaluating the impact of emergency department crowding on disposition patterns and outcomes of discharged patients

Crowding is a major challenge faced by EDs and is associated with poor outcomes.

Authors: Mahshid Abir, Jason E. Goldstick, Rosalie Malsberger, Andrew Williams, Sebastian Bauhoff, Vikas I. Parekh, Steven Kronick and Jeffrey S. Desmond